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Aaron Private Clinic Management LLC v. Berry

United States Court of Appeals, Eleventh Circuit

January 4, 2019

FRANK W. BERRY, in his official capacity as Commissioner of the Georgia Department of Community Health, and NATHAN DEAL, in his official capacity as Governor of Georgia, Defendants-Appellees.

          Appeal from the United States District Court for the Northern District of Georgia, D.C. Docket No. 1:17-cv-01034-WSD

          Before TJOFLAT, WILLIAM PRYOR, and GILMAN, [*] Circuit Judges.

          WILLIAM PRYOR, Circuit Judge:

         This appeal requires us to decide whether a limited liability company that made preliminary plans to operate a methadone clinic has standing to challenge state laws that restrict the licensure of narcotic-treatment facilities. Aaron Private Clinic Management sued certain Georgia officials after two Georgia laws temporarily suspended the issuance of new licenses for narcotic-treatment facilities and imposed additional licensing requirements for future facilities. The district court dismissed the action for lack of standing. Because the challenge to the moratorium is in part moot and because we agree with the district court that Aaron lacks standing to assert its other claims, we affirm.

         I. BACKGROUND

         Aaron Private Clinic Management is a for-profit company that asserts that it "intends to meet the standards to establish an [opioid-treatment program] in Georgia." Frank Berry is the commissioner for the Georgia Department of Community Health and, in that capacity, oversees the agency that issues licenses for narcotic-treatment facilities in Georgia. Nathan Deal is the governor of Georgia, and he has the ultimate authority to direct and control the operations of the Georgia Department of Community Health.

         In May 2017, Aaron filed a complaint alleging that two Georgia statutes violate section 504 of the Rehabilitation Act, 29 U.S.C. § 794, and Title II of the Americans with Disabilities Act, 42 U.S.C. § 12132. First, Aaron challenges a 2016 statute, which it calls the "Licensing Moratorium," that enacted "[a] temporary moratorium on the acceptance of new applications for licensure of narcotic treatment programs," O.C.G.A. § 26-5-21(e). The Licensing Moratorium prohibited new applications from being accepted between June 1, 2016, and June 30, 2017. Id. § 26-5-21(f). Second, Aaron challenges a 2017 statute, which it calls the "License Cap," that supersedes the Licensing Moratorium and provides that Georgia's Department of Community Health must establish minimum standards of quality for narcotic-treatment programs and provides for annual or biannual open-enrollment periods for program applications, see id. § 26-5-40 et seq. The License Cap also extended the prohibition on accepting new licensure applications from June 30, 2017, to December 1, 2017. Id. § 26-5-46(d).

         Aaron contends that the Licensing Moratorium and License Cap block it from establishing an opioid-treatment program and impose "arbitrary restrictions and burdens" on methadone clinics. Aaron asserts that it sues on its own behalf and "on behalf of its prospective patients who are opiate-addicted, who are qualified disabled under the [Americans with Disabilities Act], and who are prospective patients of [Aaron]." Counts one through four of the complaint assert that the Licensing Moratorium and the License Cap are facially invalid under the Rehabilitation Act and the Americans with Disabilities Act. Counts five and six assert an equal-protection challenge to the statutes, contending that "the State of Georgia's actions and disparate treatment . . . cause disproportionate impact to [Aaron] and the disabled persons [Aaron] intends to serve." Aaron requests an award of compensatory damages and litigation expenses, a permanent injunction enjoining the defendants from continuing to violate the Americans with Disabilities Act and the Rehabilitation Act by "denying or delaying [Aaron's] ability to locate an [opioid-treatment program]" in Georgia, and a declaration that the challenged statutes are void and unenforceable.

         In its complaint, Aaron alleges few facts about its plan to establish a methadone clinic. Aaron first alleges that it is a Georgia limited liability company with a principal place of business at 4403 Northside Parkway NW, Suite 1413, Atlanta, Georgia 30327. This address is the same as that of the law office of Aaron's counsel, James A. Dunlap. Aaron also alleges that it will use the "latest medical technologies, including methadone maintenance treatment, to address the physical symptoms of [opioid] addiction in combination with . . . psychotherapeutic interventions." Aaron further alleges that its prospective opiate-addicted clients are disabled under the Rehabilitation Act and the Americans with Disabilities Act, and that Aaron's programs will operate as "supervised rehabilitation programs" for persons with disabilities as described under federal law. And Aaron alleges in each count of the complaint that the challenged statutes have caused it to expend additional time and financial resources, to lose the opportunity to conduct its business, and to incur "additional costs and expenses, attorney's fees, interest, and cost of capital" from "interference and delays with planning, raising investment funds, hiring, and other normal processes related to opening a business." These allegations are all the complaint contains about Aaron's plan to establish a methadone clinic.

         Although Aaron offers few specifics about its proposed clinic, its complaint includes more detailed allegations about the need for methadone clinics in Georgia. Aaron alleges that the annual number of opioid overdose deaths in Georgia is skyrocketing, rising from roughly 200 in 2006 to nearly 1, 000 in 2015. Aaron further asserts that many of Georgia's methadone clinics are currently overcapacity and cannot accept new patients. Aaron also contends that the lack of capacity causes a variety of harms to opioid-addicted persons, who face price gouging, longer travel and wait times, and a lack of competition for treatment options. And Aaron cites evidence suggesting that methadone treatment has proven to be effective in reducing the number of drug overdoses in a community.

         After Aaron filed its complaint, the defendants moved to dismiss on several grounds, including for lack of standing. The district court granted the motion to dismiss. The court first determined that the complaint fails to establish that Aaron directly suffered an injury in fact that is "actual or imminent, not 'conjectural' or 'hypothetical.'" The court explained that the complaint alleges at most that Aaron was in the early stages of the planning process, not that it would have been prepared to offer treatment to its prospective clients but for the challenged statutes. The court also stated that, although Aaron labels the requirements imposed by the License Cap as "arbitrary and discriminatory," it fails to identify any "specific rules with which it cannot comply, and does not allege why they are discriminatory or how they prevent [it] from establishing its clinic in the future." And the court observed that Aaron has not alleged that it had applied for a license and been denied, that it would be prevented from participating in the open enrollment for new licensure applications, or that it would be unsuccessful in such applications if they were submitted. The district court also rejected Aaron's contention that it had third-party standing to assert the injuries suffered by its prospective clients. The district court ruled that Aaron's third-party-standing argument failed because Aaron did not establish that it has suffered an injury in fact, that it has a close relationship to a third party that is being discriminated against, and that there is some hindrance to the third party's ability to protect his or her own interests. See Young Apartments v. Town of Jupiter, 529 F.3d 1027, 1042 (11th Cir. 2008). Finally, the district court ruled that, even if Aaron had sufficiently alleged direct or third-party standing, it lacks statutory standing to assert these claims under either the Rehabilitation Act or the Americans with Disabilities Act.


         We review the dismissal of a complaint de novo. Culverhouse v. Paulson & Co., 813 F.3d 991, 993 (11th Cir. 2016).

         III. ...

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